This proposal requests support for the Harvard University Program in Infectious Disease and Social Change/Partners In Health/Zanmi Lasante to continue training Haitian scientists in the performance of biomedical, epidemiological, and biosocial research in the programmatic implementation of HIV prevention and treatment and the care of individual patients with HIV in rural Haiti. The program is based at Clinique Bon Sauveur in Cange, Haiti, with responsibility for the provision of healthcare services for the population of the Central Plateau. The principal investigator of this supplement is Paul Farmer, M.D., Ph.D., who is based at Harvard Medical School in the Program in Infectious Disease and Social Change. The training team has many years of experience in HIV prevention and treatment in rural Haiti including the prevention of mother-to-child transmission, diagnosis and treatment of TB and sexually transmitted disease, the prevention of opportunistic infections and the use of highly active antiretroviral therapy. The principal investigator of the AITRP grant, Dr. Warren Johnson, is a long-standing supporter of the work done in Cange and the Central Plateau, and this collaborative training program has been highly successful. The program will continue to emphasize long-term training and advanced research training in Haiti. Because HIV does not exist as a separate entity, the approach at PIH/ZL is to integrate the prevention and treatment of HIV with the most vulnerable and high prevalence groups that are seen at Clinique Bon Sauveur. HIV-related services include: 1) HIV prevention and treatment, including expansion of access to voluntary counseling and testing (VCT); 2) the screening and treatment of STIs; 3) the prevention of mother to child transmission: and 4) TB case detection, treatment, and VCT (approximately 50% of HIV patients in the central plateau present with TB). These four activities are referred to by PIH/ZL as the "four pillars" of HIV control. The overall program goal of this grant is to provide training that will increase local capacity to perform research on service integration, diagnosis and treatment of HIV in central Haiti within these four pillars of HIV control. Long-term benefits will include the increase in research capacity for future HIV-related research activities in Haiti. [unreadable] [unreadable]